A243 Intractable Hiccups: A Case of A Paraesophageal Hernia In A Roux En Y Gastric Bypass

A unique case of intractable hiccups. Patient is 48 years old with severe hiccups followed by burping which relieves his chest pain, nausea and vomiting, and severe heartburn and reflux. He has a remote history of Nissen fundoplication that was revised into a roux en y gastric bypass. He also had a prior hiatal hernia repair. This over time yielded weight loss and resolution of symptoms. The then had the above symptoms start with findings as described by the video presentation.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research

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We present a surgical technique that diminishes tension of the repair with MCPJ flexion. Twenty-two EDC tendon stabilization procedures were performed between 2006 and 2017 using a tendon flap method. The selection criteria for this group of patients included completely dislocating extensor tendons with persistent complaints of pain and decrease in finger extension despite at least a 6-week conservative treatment attempt. All subjects underwent surgical treatment for tendon centralization using a distally based tendinous flap from the EDC sutured to the adjacent finger volar plate. A mathematical model was developed to ana...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Technique Source Type: research
Radiocapitellar arthrosis represents a serious sequela of pediatric elbow injuries. Although persistent pain and disability are not uncommon in such cases, treatment remains controversial. The present study aimed to review the clinical outcomes after a new surgical treatment with partial radial head resection and corium interposition arthroplasty. To date, 3 adolescent cases underwent the surgical procedure and postoperative care. Thorough clinical and radiographic follow-up was performed. The mean age at the time of surgery was 14.4 years (range, 13 to 16 y) and mean duration of follow-up was 19 months (range, 12 t...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Technique Source Type: research
We report a novel technique of modified dorsal intercarpal ligament (DICL) capsulodesis for the treatment of SL dissociation. The surgical indication for this procedure is complete SL ligament tear with a reducible carpal malalignment and no secondary osteoarthritis. This procedure is indicated when the remnant of torn ligament in the dorsal SL interosseous space is available for repair. First, carpal malalignment is corrected and the scaphoid and the lunate are temporarily fixed with a transosseous screw or Kirschner wires. Using a dorsal approach, the DICL is then exposed, which originates from the triquetrum and attache...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Technique Source Type: research
We present a case report of an adult woman with AKL-positive ALCL, diagnosed by endobronchial ultrasound-guided transbronchial needle aspirate (EBUS-TBNA).A 59-year-old women with no history of breast implants, was admitted for a four-month low back pain. Initially, the patient was treated for a spondyloarthropathy, but due to persistence of the symptoms, a lumbosacral MRI was performed, showing changes in morphology and signal intensity in the vertebral body of L3, along with edema and a paravertebral collection that affected the left psoas muscle, suggesting granulomatous spondylodiscitis. Chest CT-scan showed mild left ...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Although the papers I have written with residents and faculty are not always accepted, most reviewers begin their comments with “This is a clearly written paper.” I think this must be why several people have asked me if I have a formula for writing research papers. The answer is yes, I do, so I decided to write this brief essay to describe it. I do this because I have learned the hard way that good data can be sunk by ba d writing and have seen the pain in some colleagues’ faces when they have a good project but can only stare at a blank computer screen, not knowing how to start.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Education Source Type: research
A 58-year-old female presents with a 1-year history of hematochezia, 20-pound weight loss, and increased straining with bowel movements. She denies increased bowel frequency or change in stool caliber. Her medical history is notable for irritable bowel syndrome, but otherwise unremarkable. She has no family history of malignancy and does not take any prescribed medications or supplements. She denies abdominal pain, bone pain, or any symptoms concerning for metastatic disease. Her initial physical examination was notable for an Eastern Cooperative Oncology Group performance status of 0, and presence on digital rectal examin...
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Gray Zone Source Type: research
Conclusions: Intraoperative liposomal bupivacaine use reduced opioid use and postoperative pain for the first 24 hours after fixation of intertrochanteric femur fractures. Significant increases in likelihood of discharge to home may present an opportunity for cost savings. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
CONCLUSION This simulation study provides important new insight into the concept of EGS regionalization, suggesting that 1 in 10 risk-adjusted deaths could be prevented by a structured system of EGS care. Future work should expand upon these findings using more complex discrete-event simulation models. LEVEL OF EVIDENCE Therapeutic/Care Management, level IV.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research
Introduction: Metabolic syndrome (MetS) is a constellation of metabolic risk factors, strongly associated with overweight and obesity that predispose to cardiovascular disease.
Source: Nutrition, Metabolism, and Cardiovascular Diseases : NMCD - Category: Nutrition Authors: Source Type: research
DiscussionRefractory GERD can be surgically managed with various techniques. In obese individuals, laparoscopic Roux-en-Y gastric bypass should be considered due to significant symptom improvement and lower incidence of recurrent symptoms with weight loss. Otherwise, laparoscopic Nissen fundoplication is the preferred surgical technique for treatment of this disease with concomitant hiatal hernia repair when present for either procedure. The short-term risks associated with these procedures include esophageal or gastric injury, pneumothorax, wound infection, and dysphagia. Emerging techniques for treatment of this disease ...
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
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